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BMS2011 > Digestive system > Flashcards

Digestive system Flashcards

1
Q

What is pelvic inlet?

A

Pelvic inlet = area where we pass from abdomen down into pelvis.

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2
Q

What is everything above and below pelvic inlet?

A

Everything above pelvic inlet is abdomen.

Everything below pelvic inlet is pelvis.

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3
Q

Where is rectum located?

A

Rectum will be within abdominal cavity, but major part will be within pelvis.

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4
Q

Does oesophagus have a thoracic part only, or both thoracic and abdominal part?

A

Oesophagus has a thoracic and abdominal part.

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5
Q

Which membrane is the peritoneum enclosed by?

A

Peritoneum.

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6
Q

Is parietal peritoneum sensitive or insensitive to pain?

A

Due to somatic afferent innervations of the parietal peritoneum, it is sensitive to pain.

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7
Q

What are organs inside peritoneal cavity called?

A

Intraperitoneal organs.

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8
Q

What layer of peritoneum are intraperitoneal organs covered by?

A

Intraperitoneal organs are covered by a layer of peritoneum called visceral peritoneum.

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9
Q

What is visceral peritoneum is innervated by what?

A

Visceral peritoneum is innervated via visceral afferents, and join sympathetic and parasympathetic fibres back to the nervous system.

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10
Q

Where does the greater sac extend from, and to what?

A

Greater sac, which extends from diaphragm to down to pelvic cavity.

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11
Q

Lesser sac is behind what and what does it connect to?

A

Lesser sac is behind liver and stomach and connect with greater sac at the epiploic foramen.

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12
Q

At what site do lesser and greater sac connect?

A

Epiploic foramen

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13
Q

Where are peritoneal folds located?

A

Within peritoneal cavity, we have peritoneal folds.

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14
Q

What is the purpose of peritoneal fold?

A

It is to connect organs with each other.

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15
Q

What are the two forms that folds can appear in?

A

Folds can appear in different forms:
Omenta: greater and lesser omenta:

Mesenteries and ligaments:

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16
Q

What is the part of peritoneal fold that attaches to duodenum and liver called? And what is the part that attaches to stomach and liver called?

A

Part of peritoneal fold that attaches to duodenum and liver, we call it hepatoduodenal ligament.
Part that attaches to stomach and liver is called hepatogastric.

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17
Q

Hepatoduedenal ligament has a __ edge.

A

Hepatoduodenal ligament has a free edge and this what forms one of the borders of epiploic foramen.

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18
Q

What does the lesser and greater momentum attach to?

A

Lesser omentum attaches to lesser curvature of stomach, but greater omentum attaches to greater curvature of stomach.

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19
Q

What does the transverse colon move over?

A

Moves over transverse colon of large intestine and jejunum/ileum of small intestine.

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20
Q

What does the greater omentum attach to? What is the function of this thing that omentum attaches to?

A

Omentum attaches on mesocolon and then attaches to posterior abdominal wall and so it offers some sort of stability, but also insulation to abdominal organs in this area.

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21
Q

What is mesentery proper?

A

Attaches the jejunum and ileum of small intestine to posterior abdominal wall.

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22
Q

What does the transverse mesocolon connect? What is the function of this part?

A

Transverse colon of large intestine to posterior abdominal wall.
Offers stability to large intestine.

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23
Q

What does the sigmoid mesocolon connect?

A

Sigmoid colon of large intestine to posterior abdominal wall.

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24
Q

What is the pathway of food, especially explaining the pathway in the GI tube.

A
  • Process food in the oral cavity. We have a lot of chemical and mechanical digestion.
    • Goes down oropharynx -> then laryngopharynx -> gets down the GI tube.
    • Gut tube will take food from esophagus -> to stomach -> to small intestine -> to large intestine -> to rectum.
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25
Q

What type of muscles does the GI tube have? Where are these muscles located?

A

GI tube has striatic muscles for voluntary control, especially when you are taking food into it via esophagus, and during outflow of food into anus.

Striatic muscles only located at its ends.

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26
Q

What are primary and secondary organs? And list all primary and secondary organs in the GI tube.

A

Primary organs come in direct contact with food. Abdominal oesophagus, stomach, small intestine and colon.

We also have accessory organs; diverticula; liver, gallbladder, pancreas. These are secondary organs as they do not come in direct contact with food, instead via secretion of enzymes and fluids, they help into the digestion process.

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27
Q

What helps bolus move from one end of tube to another?

A

Behind bolus of food, longitudinal muscle relaxes and circular contracts. This helps bolus to move from one end of tube to the other.

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28
Q

What happens when food gets into stomach and intestine?

A

Once food gets into the stomach, there is a lot of backwards and forwards movement of digestive material and this helps convert digestive material into chyme. So a lot of segmentation and trituration (crushing and grinding) takes place in the stomach.

Once food gets into intestines (duodenum and jejunum), it is major site of absorption. Absorption involves either passive movement or active transport of electrolytes, digestion products and vitamins and also water across epithelium of GI tract and -> into GI track, blood and lymph vessels.

Via

Reservoir of food storage is in stomach, colon and rectum and anus.

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29
Q

What happens to indigestible food?

A

Everything that is indigestible and all of the waste products will be secreted and -> into large intestine -> then it will become solidified and compacted into faeces -> move down into rectum for storage -> they will eliminate the body via anal canal.

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30
Q

What are lower oesophageal, pyloric, sphincter of Oddi, ileocolic sphincter?

A

Lower oesophageal sphincter = located junction b/w abdominal oesophagus and stomach.
Pyloric sphincter = located b/w pylorus of stomach and duodenum of small intestine
Ileocolic sphincter = Ileum of small intestine connects with caecum of large intestine.
Closure of sphincter of Oddi causes bile to back up and be stored in the gall bladder.

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31
Q

What is failure of sphincters to open called?

A

Achalasia

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32
Q

What does the thoracic oesophagus pass through?

A

Thoracic oesophagus passes through diaphragm via oesophageal hiatus, which connects to cardiac orifice of the stomach.

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33
Q

Which areas are related to abdominal oesophagus?

A

Left lobe of liver and Vagus nerves on front and back.

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34
Q

What innervates the abdominal oesophagus?

A

Vagus and sympathetic T1-T5.

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35
Q

Where does abdominal oesophagus get its blood from?

A

It gets blood via the branches of celiac trunk, that is located anteriorly to the abdominal aorta, and supplying the blood to the organs of digestive system.

It also gets blood via inferior phrenic arteries, which are branches of abdominal aorta.

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36
Q

What is the major function of abdominal oesophagus?

A

It is to transfer food from thoracic oesophagus down to stomach.
Oesophagus as a whole takes food down from pharynx into stomach.

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37
Q

Define lower oesophageal sphincter.

A

Area where the abdominal oesophagus connects with the stomach is lower oesophagus sphincter.

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38
Q

Why is lower oesophageal sphincter defined as a “physiological” sphincter and not an anatomical one?

A

1). No thick, muscular layers to form this sphincter (anatomical one).
Via tonic contractions and diaphragm, lower oesophageal sphincter will close and prevent reflex of food from stomach back into oesophagus.

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39
Q

What quadrant does stomach lie in the abdomen?

A

Stomach lies in upper left quadrant of abdomen.

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40
Q

What is cardia of stomach? Where is it located?

A

Cardia of stomach = part of stomach that is closest to the oesophagus.
Cardia of stomach is inferior to the heart.
Cardia region is located around T10 level of thoracic spine.

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41
Q

What does the most distal part of stomach connect with?

A

Most distal part of stomach will connect with the duodenum of small intestine via the pylorus.

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42
Q

What level does pylorus extend with?

A

Pylorus extends at the level of L1 vertebra.

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43
Q

Which areas does the stomach relate to?

A
  • Anterior abdominal wall
    • Diaphragm
    • Left lobe of liver
    • Superiorly stomach relates with abdominal oesophagus
    • Inferiorly duodenum relates with duodenum of small intestine.
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44
Q

How are pancreas, transverse colon of large intestine of spleen, left kidney and left adrenal glands related to stomach?

A
  • Pancreas: posterior to stomach
    • Posterior surface of stomach related to transverse colon of large intestine of spleen
      Left kidney and left adrenal glands.
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45
Q

What are the four parts that the stomach is divided into?

A

Fungus: superior part: area that is always filled with gases due to swallowed air.

Cardia: Area around the lower oesophageal sphincter.

Body: Largest part; it has greater and lesser curvature. And curvature is attachment site for omentum.

Pyloric region
Pylorus: connects stomach with duodenum.

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46
Q

What are rugae?

A

Circular folds within the stomach. They help increase the surface area of stomach as it has a lot of mechanical and chemical digestion taking place within the stomach.

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47
Q

What are the layers of the stomach?

A

Longitudinal, circular and oblique layer, which all help with trituration of the grinding of food.

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48
Q

What are the sphincters of the stomach? What is its function?

A

Lower oesophageal sphincter (physiological and not anatomical) and pyloric sphincter.
Thickened muscle in LES helps regulate passage of chyme from stomach down into the duodenum.

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49
Q

What do the lesser and greater omentum attach to? What are their functions.

A

Lesser omentum attaches to lesser curvature and proximal duodenum. It stabilises position of stomach.

Greater omentum attaches to greater curvature. Its adipose tissue protects the abdomen.

50
Q

What do the lesser and greater omentum house?

A

Blood vessels and nerves of stomach.

51
Q

What is the stomach secreting?

A

Stomach secretes parietal cells which secrete HCI. HCI has the ability to change ingested proteins and make them even more digestible.

52
Q

Where does most of the nutrients get absorbed?

A

Most of nutrients gets absorbed into small intestine.

53
Q

What are the two functional divisions of the stomach?

A

Proximal stomach (reservoir) specialized for tonic contractions Functions to maintain constant pressure on contents within stomach, which vary in volume and solidity.

The antral region is area that controls passage of food from stomach to duodenum.
This is creating the trituration of food.

54
Q

What happens when the pyloric sphincter is closed?

A

If pyloric sphincter is closed, retropulsion occurs back into stomach, triturating food.

55
Q

What are the three parts of the small intestine?

A

It consists of three parts:
Duodenum: Most proximal part of small intestine, this is the part of small intestine that connects with the stomach or pylorus.

Jejunum: Connects with the duodenum at the jejunal flecture.

Ileum: Distally, ileum will connect with the large intestine, caecum of large intestine via ileocecal valve.

56
Q

What is pyloric sphincter?

A

Area where duodenum connects with the stomach of the pylorus.

57
Q

Is duodenum retroperitoneal?

A

Duodenum is retroperitoneal because it is located behind the peritoneal cavity , apart from the proximal part, which is intraperitoneal.

58
Q

Where is the hepatoduodenal ligament with respect to the duodenum?

A

Proximal to the part of duodenum, there is hepatoduodenal ligament, that attaches from this area up into the liver.

59
Q

Does the whole duodenum have a mesentery and is it mobile?

A

First two cm of duodenum, attached to pylorus has a mesentery, is mobile and therefore it is intraperitoneal. Remaining duodenum is retroperitoneum. It has no mesentery and it is immobile.

60
Q

Where does the first part of duodenum run to? Why is it called a free part?

A

First part of superior part runs from pylorus of stomach -> then runs to right of inferior vena cava.

First part is called free part because it is not attached to posterior abdominal wall. Instead it is the intraperitoneal part that attaches via ligaments to lesser omentum and to liver.

61
Q

What is the 2nd part of duodenum?

A

This is the area where the embryological foregut and midgut meet.
Mid gut starts from major duodenum papilla.

62
Q

What is the function of the major and minor duodenum papilla?

A

Major: Helping empty the bile that gets into the duodenal from the bile duct, but also the pancreatic enzymes that get into duodenal from pancreatic duct to break down acidity of the chyme.

Minor: Area where accessory pancreatic ducts release more pancreatic acids.

63
Q

Where does the inferior part of duodenum run to?

A

The inferior part of the duodenum runs to the left of the structure. It goes over the inferior vena cava, over the aorta and proceeds to the left of the psoas muscle.

64
Q

What is the ascending part of duodenum? What does it connect to? What is the name of the ligament you find here?

A

Ascending part of duodenum is a short segment, that moves upwards and connects with the duodenojejunal flexure, and you find a ligament here called the ligament of Treitz.

65
Q

What shape is the duodenum?

A

C-shaped structure.

66
Q

What are the functions of the small intestine?

A

Important digestive and absorptive functions (carbohydrates, proteins, and fat) – Secretions and buffers provided by pancreas, and gall bladder (liver).

67
Q

What is the duodenum covered by?

A

By a lining of mucous membrane which protects the epithelium from the acid chyme that comes from the stomach.

68
Q

What is the function of the jejunum? Where does it begin and what is its boundary?

A

Important digestive and absorptive functions (carbohydrates, proteins and fat).
It begins at the duodeno-jejunal flexure and has no clear anatomical boundary with ileum.

69
Q

What is mesentery proper?

A

Mesentery proper = massive part of peritoneum fold that attaches to the small intestine.

70
Q

Is duodenum, jejunum and remaining intestine intraperitoneal or retroperitoneal?

A

Duodenum is retroperitoneal.

Remaining intestine is intraperitoneal, so Jejunum is intraperitoneal.

71
Q

What is the function of the jejunum? Where does it begin and what is its boundary?

A

Important digestive and absorptive functions (carbohydrates, proteins and fat).
It begins at the duodeno-jejunal flexure and has no clear anatomical boundary with ileum.

72
Q

What is the jejunum attached by?

A

Mesentery proper

73
Q

What is the function of Ileum?

A

Ileum is the area where less absorption happens. You don’t have a lot of carbs, proteins and fats there.
Absorption of vitamin B12; salts and all products of digestion that were not absorbed by the jejunum.

74
Q

What is the Ileum attached to?

A

Mesentery proper.

75
Q

What is the ileocecal valve?

A

Ileocecal valve = area where ileum connects with the caecum of large intestine.

76
Q

What are the functions of plicae circulares (circular folds) in the duodenum/jejunum and ileum?

A

Function of these folds is to increase surface area of this parts of the small intestine that have very important absorptive functions so that they facilitate absorption.

77
Q

Compare the duodenum/jejunum with the ileum in terms of frequency of circular folds (plicae circularis).

A

Ileum doesn’t have enough of circular folds as duodenum and jejunum. This is because the ileum doesn’t have as important functions as the duodenum and jejunum.

78
Q

Compare Jejunum and ileum.

A

Jejunum:

  • Long vasa recta
  • Short arterial arcades
  • Thicker internal walls
  • Less fat in mesentery
  • Large, tall plicae circulares

Ileum:

  • Short vasa recta
  • Long arterial arcades
  • Thinner internal walls
  • More fat in mesentery
  • Low, sparse-absent plicae
    • Smaller plicae circulares and circular folds.
79
Q

What is the first part of ascending colon?

A

Caecum

80
Q

What is hepatic and splenic flexure?

A

Hepatic: Liver is located right part of the body.
Splenic: Part that is located at the left side of the body.

81
Q

What are the connections at the start of the large intestine and its end?

A

Ileum of small intestine connects with area of caecum, and ends distally to connect with the rectum.

82
Q

Where does the large intestine lie around?

A

Large intestine lies around edges of abdominal pelvic cavity.

83
Q

What are the two mesocolon that attaches to the large intestine?

A

It has a big mesocolon at the transverse colon, called transverse mesocolon.
Mesentery that attaches to sigmoid colon is sigmoid mesocolon.

84
Q

What are the 4 colons of large intestine?

A

Ascending, transverse, descending and sigmoid.

85
Q

What is the function of the large intestine?

A

Converts liquid indigestible material to a semisolid state via water, electrolyte and salt absorption  Stores and lubricates faecal material.

86
Q

What is appendix?

A

Appendix is structure that attaches to caecum of large intestine.

87
Q

Where is the appendix located?

A

In most people, appendix is retrocecal, so behind the caecum.
But in some people, it is more pelvic or sub-cecal or postileal, which means behind ileum or preilial, which means infront of ileum.

88
Q

What is taenia coli, and where is its relationship with taenia coli?

A

Appendix follows taenia coli.

Taenia coli = aggregation points of smooth muscle that we have on the large intestine.

89
Q

What does free tania have attached to it?

A

Free taenia has little appendices attached to it.

90
Q

What is appendix filled with?

A

Appendix is filled with lymphoid tissue.

91
Q

What is released when chyme gets down from stomach in to duodenum and jejunum of small intestine?

A

Release of the cholecystokinin peptide hormone and this CCK hormone triggers release of bile.

92
Q

Where is bile produced and stored?

A

Bile is produced in liver but is stored in gall bladder. When CCK triggers it, it becomes released down into the duodenum to help breakdown acidity of chyme.

93
Q

What gets secreted when food is in the stomach?

A

Pancreatic juices or enzymes are secreted continuously from pancreas down into the duodenum when food is in the stomach.

94
Q

What are the functions of the liver?

A
  • It produces bile, metabolises carbs for other protein.

- Helps filtrate blood from the intestines.

95
Q

Where is the liver in relation to the diaphragm?

A

It sits underneath the diaphragm.

96
Q

Is the liver intraperitoneal?

A

Yes. It is covered by connective tissues capsule and layer of visceral peritoneum, except posterior aspect of liver (called bare area).

97
Q

Which ligament connects the right and left lobe to diaphragm?

A

Coronary ligament.

98
Q

Which ligament connects the left and right lobe and secures the liver to the anterior abdominal wall?

A

Falciform ligament

99
Q

What is ligamentum teres?

A

Remnant of the fetal umbilical vein.

100
Q

What are the components of porta hepatis?

A

Hepatic artery:
Hepatic artery branches of the celiac trunk to supply with blood to the liver.

Hepatic ducts:
These are ducts that receive bile produced in the liver and take bile down into the rest of the billary system before it goes to the gall bladder.

Gall bladder:

Portal vein:

Nerves:

Lymph nodes:

101
Q

Why are visceral anatomical lobes not functional?

A

Visceral anatomical lobes are not functional because internally the liver looks almost continuous with no lobar division.

102
Q

What happens if you remove function segment of liver with its blood supply?

A

If you remove functional segment of the liver with its blood supply, then it’s going to have ability to regenerate.

103
Q

How much percentage do portal veins and hepatic artery contribute to the volume entering the liver?

A

Portal veins contributes 75% of blood volume of liver (rich in nutrients and poor in oxygen).

Hepatic artery contributes to 25% of blood volume entering the liver (rich in oxygen and poor in nutrients).
Celiac trunk branches into hepatic artery -> this supplies with oxygen rich blood to liver.

104
Q

Do blood from portal veins and hepatic artery mix?

A

Blood from portal veins and hepatic artery mix, as it enters and passes through a liver lobule.
Then the blood is collected by the hepatic central vein. The hepatic vein carries 100% of the blood out of the liver and into the inferior vena cava.

105
Q

What is the function of gallbladder?

A

Major function is to store and concentrate bile that has been produced by the liver. Concentration happens by absorbing salt and water.

Liver produces bile.
Bile flows from liver into right and left hepatic ducts -> bile gets down into common hepatic duct -> then to cystic duct -> then to gall bladder (stays in here for concentration and storage) -> triggering from the CCK peptide hormone -> then gall bladder releases this bile back into the cystic duct -> into common bile duct -> into duodenum via hepatopancreatic ampulla and major duodenal papilla and into duodenum.

106
Q

What does it mean when we say that pancreas are secondary retroperitoneal organ?

A

Pancreas is secondary retroperitoneal organ, which means during development it once had the mesentery, but then it lost it.

107
Q

Where is the pancreas located in relation to the stomach and duodenum and spleen.

A

Pancreas is located behind the stomach and is located between duodenum and spleen.

Now, the pancreas has two major functions and therefore two functional divisions.

108
Q

What are the divisions of the pancreas and what are their locations?

A

Head of pancreas sits within the C shaped cavity of the duodenum and it is located to the right of renal vessels, inferior vena cava, superior mesenteric artery and superior mesenteric vein.

Uncinate: Behind superior mesenteric artery and superior mesenteric vein.
Neck: Over superior mesenteric artery and superior mesenteric vein.

Body: left of the superior mesenteric artery, superior mesenteric, and over aorta at level of 2nd lumbar vertebra.

Tail: Goes over left kidney and projects towards spleen.

109
Q

What are the two divisions of the pancreas and what are their functions?

A

Endocrine pancreas: which consists of tail and islets of langerhans. It secrete hormones

Exocrine pancreas: It is involved in secretion of bicarbonate ions and pancreatic enzymes that via pancreatic duct help neutralise activity of chyme that reaches the duodenum.

110
Q

Pancreatic duct transverses length of gland, and joins common bile duct and then secretes together what?

A

the bile and pancreatic juices into duodenum via major duodenal papilla.

111
Q

How does abdominal aorta get to the abdomen?

A

Abdominal aorta gets via the aortic hiatus from the thorax to the abdomen.

112
Q

What are the locations of the 3 major vessels in abdominal aorta?

A

Abdominal aorta has 3 major vessels, celiac trunk, superior mesenteric artery and inferior mesenteric artery.

Celiac trunk arises below aortic hiatus.

Superior mesenteric artery branches above the level of first lumbar vertebra, just below the celiac trunk.

Inferior mesenteric artery arises anterior to body of L3.

113
Q

Why does the celiac trunk only supply to superior aspects of pancreas and duodenum?

A

The celiac trunk supplies to all organs (abdominal oesophagus, liver, stomach, spleen, gallbladder, superior aspects of pancreas and superior aspects of duodenum).

114
Q

To what organs does the celiac trunk supply blood to?

A

Both organs are located above and below transverse mesocolon.

115
Q

To which areas does the inferior mesenteric artery supply blood to?

A

Supplies (left side of mesenterium):
• Descending & sigmoid colon of Large Intestine
• Last third of transverse colon of Large intestine
• Upper rectum

116
Q

What is the blood from digestive abdominal organs drained via? What do we call his system?

A

Via a network of veins.

Hepatic portal system.

117
Q

What is the blood from digestive abdominal organs drained via? What do we call his system?

A

Via a network of veins.

Hepatic portal system.

118
Q

Describe the pathway of blood with toxins to detoxify it.

A

Blood that drains into digestive organs has a lot of toxins and waste in it.
So you don’t want this blood to get straight away to the inferior vena cava and then into the heart.
This blood via hepatic portal system will get into liver.
This is where detoxification and cleaning of this blood will happen and oxygen poor blood will get into inferior vena cava and into the heart.

119
Q

Which unpaired organs does the hepatic portal vein drain?

A

Spleen, liver, pancreas, stomach, intestines.

120
Q

Which structures does the inferior mesenteric vein drain into?

A

The inferior mesenteric vein will drain all of the structures and organs that the inferior mesenteric artery supplies blood with. Drains in the splenic vein and then -> into the hepatic portal vein.

Which structures does the superior mesenteric vein drain into?
Superior mesenteric vein will drain all of the organs of the superior mesenteric artery, that supplies with blood and takes the blood straight into the hepatic portal vein.

Superior mesenteric vein drains the rectum, sigmoid colon, descending colon, splenic flexure of the large intestine.

121
Q

What are the blood vessels that form the hepatic portal system?

A

Blood vessels that form the hepatic portal system is the hepatic portal vein and its tributaries, which is the spleen and superior mesenteric vein. In most cases, inferior mesenteric vein will drain into the splenic vein.

BMS2011 (14 decks)

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